We present a case of a 58 years old woman who presents a low-anterior dislocation with vascular and total nerve injury
secondary to a fall with the shoulder extended and abducted (90º). In this situation, it was fixed with closed reduction.
After 6 weeks, the ENG and the EMG showed brachial plexopathy. Disruptions were not detected in NMR. She gradually
improved with rehabilitation, not having new vascular symptoms. Age, obesity, the delay until the reduction and associated
fractures are risk factors to completed brachial plexus palsy, being more common in low energy traumas. Axilar nerve is
the most affected element, followed by radial, ulnar and median, in this order. EMG/ENG is the gold standard technique
for the diagnosis after one month. MNR will be essential to check the state of the nerve. Rehabilitation is key in the
treatment, and the surgery can be postponed. Neurolysis showed encouraging results in the first semester. Functional
recovery is slow (six months - one year), being faster in the EMG results. Acute vascular affection is a traumatology
emergency. The third section of the axillar nerve is the most common affected. Suspected diagnosis is important, even
when the radial pulse is detected. After closed reduction, ECO-Doppler and CT Angiography are the diagnosis test
indicated. Suspecting neurovascular injury is mandatory. Systematic exploration and urgent treatment decrease
complications and they can improve the patient prognosis.

We present a case of a 58 years old woman who presents a low-anterior dislocation with vascular and total nerve injury
secondary to a fall with the shoulder extended and abducted (90º). In this situation, it was fixed with closed reduction.
After 6 weeks, the ENG and the EMG showed brachial plexopathy. Disruptions were not detected in NMR. She gradually
improved with rehabilitation, not having new vascular symptoms. Age, obesity, the delay until the reduction and associated
fractures are risk factors to completed brachial plexus palsy, being more common in low energy traumas. Axilar nerve is
the most affected element, followed by radial, ulnar and median, in this order. EMG/ENG is the gold standard technique
for the diagnosis after one month. MNR will be essential to check the state of the nerve. Rehabilitation is key in the
treatment, and the surgery can be postponed. Neurolysis showed encouraging results in the first semester. Functional
recovery is slow (six months - one year), being faster in the EMG results. Acute vascular affection is a traumatology
emergency. The third section of the axillar nerve is the most common affected. Suspected diagnosis is important, even
when the radial pulse is detected. After closed reduction, ECO-Doppler and CT Angiography are the diagnosis test
indicated. Suspecting neurovascular injury is mandatory. Systematic exploration and urgent treatment decrease
complications and they can improve the patient prognosis.